Individual provider Active NPI

Vijaya Guduri

  • Internal Medicine Physician
  • Hollywood, MD
National Provider Identifier
1386825271
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0068923 Issued in MD
Practice address
24035 Three Notch Road
Shah Associates MD LLC
Hollywood, MD 20636
Phone
(301) 373-7100
NPI assigned
Nov 19, 2007
Last updated
Dec 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0068923 MD Primary

Addresses

Primary practice location

24035 Three Notch Road
Shah Associates MD LLC
Hollywood, MD 20636

Mailing address

PO Box 64522
Baltimore, MD 21264-4522

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, VA, DC3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20091023000482 MD Practitioner - HospitalistPractitioner - Internal Medicine 1759428766 Reassigns benefits to 6 organizations
I20240103002725 VA Practitioner - HospitalistPractitioner - Internal Medicine 1759428766 Reassigns benefits to 2 organizations
I20240110005154 DC Practitioner - HospitalistPractitioner - Internal Medicine 1759428766 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, shared by 17 NPIs, 1,921 clinicians

Practice addresses (Care Compare)

13285 Minnieville Rd
Woodbridge, VA 22192-4018
Phone (703) 986-2400

2391 Greenspring Dr
Timonium, MD 21093-6038
Phone (301) 816-2424

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0068923MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Current Accepting new patients
Luminis Health Medical Group, LLC Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jan 8, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jan 8, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jan 8, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jan 8, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jan 8, 2024 Accepting new patients
Mdics at Anne Arundel LLC CurrentSince Jun 1, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jan 8, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jan 8, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jan 8, 2024 Accepting new patients
Mdics at Umroi, LLC CurrentSince Apr 1, 2016 Accepting new patients
Luminis Health Medical Group, LLC Internal Medicine CurrentSince Mar 6, 2019 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Mar 6, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Internal Medicine CurrentSince Jan 8, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jan 8, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Internal Medicine Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jan 8, 2024 Accepting new patients
University of Maryland St. Joseph Medical Center, LLC Past Accepting new patients
Luminis Health Anne Arundel Medical Center, Inc. Past Accepting new patients

Locations

2001 Medical Pkwy
Annapolis, MD 21401
Phone (410) 280-5601

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

904 Commerce Rd
Annapolis, MD 21401
Phone (410) 849-6140

7070 Samuel Morse Dr
Columbia, MD 21046
Phone (410) 309-4600

7190 Crestwood Blvd
Frederick, MD 21703
Phone (240) 529-1700

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

1701 Twin Springs Rd
Halethorpe, MD 21227
Phone (410) 737-5000

10810 Connecticut Ave
Kensington, MD 20895
Phone (301) 929-7100

1221 Mercantile Ln
Fl 3
Largo, MD 20774
Phone (301) 618-5500

655 Watkins Mill Rd
Montgomery Village, MD 20879
Phone (301) 929-7100

2101 E Jefferson St
#4E
Rockville, MD 20852

2101 E Jefferson St
Ste 4EAST
Rockville, MD 20852

2101 E Jefferson St
Ste 4EPFS
Rockville, MD 20852

2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853

2391 Greenspring Dr
Timonium, MD 21093
Phone (410) 847-3000

6701 N Charles St
Towson, MD 21204
Phone (443) 849-2000

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

2200 Kernan Dr
Woodlawn, MD 21207
Phone (410) 448-2500

8008 Westpark Dr
Tysons Corner, VA 22102
Phone (703) 287-6400

13285 Minnieville Rd
Woodbridge, VA 22192
Phone (703) 986-2400

14139 Potomac Mills Rd
Woodbridge, VA 22192
Phone (703) 257-3000

Interoperability endpoints

  • Direct secure messaging: vguduri265294@direct.umm.edu

Organizations & group practices 20

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 20

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1386825271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64522",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24035 THREE NOTCH ROAD",
            "address_2": "SHAH ASSOCIATES MD LLC",
            "city": "HOLLYWOOD",
            "state": "MD",
            "postal_code": "20636",
            "telephone_number": "301-373-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUDURI",
        "first_name": "VIJAYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-19",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0068923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "24035 Three Notch Road",
            "address_2": "Shah Associates MD LLC",
            "city": "Hollywood",
            "state": "MD",
            "country_code": "US",
            "postal_code": "20636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hollywood, MD

Sources for this page

Verify at the official NPI Registry.